Nursing Specialties (page 2)
Nursing has come a long way from the days when caring for the sick in hospitals was seen as the sole nursing role. While nurses still care for ill clients, many of these clients are in the community or at home. Nurses also focus on wellness and health maintenance, as well as the psychological, cognitive, social, and spiritual needs of clients.
Many of the nursing specialties described here require that you be a registered nurse, and some require additional training. But these requirements may vary per institution, so if a hospital or outpatient center has your special area of interest and you are a practical nurse, ask them about the requirements before you rule them out. Many specialties have available certifications. Most of these certifications require that you have experience, continuing education in the specialty, and a certification exam.
Ambulatory Care Nursing
American Academy of Ambulatory Care Nurses: www.aaacn.org
Ambulatory care nursing is characterized by rapid, focused assessments of patients, long-term nurse/patient/family relationships, and teaching and translating prescriptions for care into doable activities for patients and their caregivers. The emphasis is on pain management and client education to keep people with injuries and chronic injuries healthy and independent in their home surroundings. Ambulatory care nurses respond rapidly to high volumes of patients in a short period of time and deal with issues that are not always predictable. Ambulatory care nurses work in community-based hospitals, schools, workplaces, and homes. Client encounters may be face-to-face, via phone, or via another communication device.
Association of Camp Nurses: www.campnurse.org
Camp nurses work in traditional camps or camps for children with disabilities or chronic illnesses, either of which may be day camp or residential. They provide routine and emergency care to children and staff, monitor children with chronic diseases, educate campers and staff on prevention, and collaborate with camp administrators to develop and implement policies that reduce the risk of injury or illness. Flexibility, critical thinking skills, and problem solving skills enable camp nurses to protect and promote the health of the entire camp community. Humor and creativity help, too. Camp nurses deal with problems as simple as lice and as complex as diabetes or HIV/AIDS. They review health records, assess, administer medications, dress wounds, calm separation anxiety, and manage behavioral problems. Camp nurses also attend to the needs of staff, who may present with illnesses, infections, or injuries.
Cardiac Rehabilitation Nursing
Association of Rehabilitation Nurses: www.rehabnurse.org
Cardiac rehabilitation nurses provide assessment, support, and education for clients with heart disease who need to make lifestyle changes to prevent their disease from getting worse. They work in hospitals, ambulatory care, and fitness centers, and their clients include people recovering from heart attacks or heart surgery. Cardiac rehabilitation nurses monitor these clients during exercise to prevent injury and overexertion, promote stress management, and teach healthy diet, adequate exercise, and smoking cessation. ANCC provides certification as a cardiac rehabilitation nurse.
Case Management Nursing
Case Management Society of America: www.cmsa.org
Case management nurses organize and coordinate individualized resources and services for clients. They work with clients of all ages, with all types of illnesses and health problems and in all types of healthcare settings, but many target specific populations, such as older adults or people post organ transplant. The case manager's goal is to foster quality self-care. Case managers use a plan of care called clinical pathway to assess the needs and progress of their clients. ANCC offers certification for nurses as case managers.
College Health Nurse
American College Health Association: www.acha.org
College health nurses work in college health centers to assist students with health maintenance, illness prevention, and illness management. They also maintain health records and assure that immunizations and other wellness needs are up-to-date. Since most students are young adults, college health nurses focus on issues such as dating safety, sexually transmitted disease prevention, and sports injury prevention. However, as more adults return to college, college health nurses face new challenges, such as the prevention of cardiovascular problems. Most illnesses and injuries are minor, like sore throats and sprained ankles, but college nurses still need to be ready for emergencies, including ones related to psychiatric disorders. ANCC provides certification for college health nurses.
Community Health Nurses
Association of Community Health Nurse Educators: www.achne.org
Community health nurses work in the field through government and private agencies. They work with individuals, families, and groups to improve their overall health by educating them about common issues such as illness prevention, parenting, elder care, and healthcare problems, as well as issues pertinent to that community such as lead poisoning and farm safety. Community health nurses provide home follow-up care, immunization clinics, health education, and referral of clients to appropriate agencies for assistance. Community health nurses need to be well versed in disaster management including sudden mass casualty incidents, unfolding infectious disease outbreaks, or evolving environmental disaster. While bioterrorism is always a concern, flooding is more commonplace and often just as deadly. ANCC offers certification for community health nurses.
Correctional Health Nursing
American Correctional Health Organization: www.achsa.org
National Commission on Correctional Health Care: www.ncchc.org
Correctional health nursing provides freedom of practice in a restricted environment—jails and prisons. Correctional nurses remain neutral and unbiased by their clients' offenses and assure that their clients receive the same healthcare treatment they would receive if not incarcerated. One of the key issues in correctional health is the issue of custody versus care. Correctional nurses provide quality care within the necessity of custody because safety comes first. Correctional nurses care for their clients from intake until release and must be proficient in assessment, infectious diseases, responding to emergencies, the needs of an aging prison population, and managing chronic illnesses and psychiatric disorders. They also need to differentiate legitimate complaints from malingering in clients who can be very manipulative. There are a number of opportunities for growth in the corrections field, with roles ranging from staff nurse to manager to nurse practitioner to director. Nursing does not offer certification in correctional health; however the National Commission on Correctional Health Care (NCCHC) offers basic and advanced certification in correctional health care called the Certified Correctional Health Professional (CCHP).
Critical Care Nursing
American Association of Critical-Care Nurses: www.aacn.org
Critical care nurses work with clients who have life-threatening conditions due to illness, injury, or major surgery. They provide complex assessment, high-intensity interventions, and continuous nursing care. Critical care nurses require a specialized body of knowledge, experience, and skills to provide care to patients and their families. Critical care nurses work in a variety of intensive care units: cardiac, burn, medical, surgical, neurological, neonatal, and pediatric. The American Association of Critical-Care Nurses provides certification programs for the following subspecialties: adult, neonatal, pediatric, progressive care, cardiac medicine, cardiac surgery, and nurse manager and leader.
Developmental Disabilities Nursing
Developmental Disabilities Nursing Association: www.ddna.org
Developmental disabilities nurses work with clients who have developmental disabilities, including mental retardation and autistic spectrum disorders. These clients range in age from infant to older adult and many have associated problems such as cerebral palsy, hearing and/or visual impairment, and seizure disorders. Developmental disability nurses provide holistic care, meeting the client and family's physical, cognitive, emotional, social, and spiritual needs. The Developmental Disabilities Nursing Association provides a certification program for developmental disabilities nurses.
Emergency Nurses Association: www.ena.org
Emergency nursing crosses all ages and areas of nursing to provide care that include birth, death, injury prevention, women's health, disease, and life and limb saving measures. Emergency nurses apply the nursing process to clients of all ages requiring stabilization and/or resuscitation for a variety of illnesses and injuries. Emergency nurses work in hospital emergency departments; military settings; clinics, health maintenance organizations, and ambulatory care centers; business, educational, industrial, and correctional institutions; and other healthcare environments. Emergency care also happens at the point of contact, where clients live, work, play, and go to school. The Emergency Nurses Association provides certification for emergency nurses, pediatric emergency nurses, and ground transportation nurses.
Air and Surface Transport Nurses Association: www.astna.org
Flight nurses care for emergent and nonemergent clients during surface and air transportation, including interfacility transport and emergency scene calls for medical emergencies and trauma. Cases range from the simple to the challenging. Prerequisites to becoming a flight nurse include three to five years of critical care nursing, Advanced Cardiac Life Support (ACLS) certification, and usually Pediatric Advanced Life Support (PALS) certification. Flight nurses are employed by trauma centers and other acute care facilities, public and private transport companies, and the military. The Air and Surface Transport Nurses Association (ASTNA) provides certification as either a certified flight registered nurse or certified transport registered nurse. The Board of Certification of the Emergency Nurses Association also provides certification for flight nurses.
International Association of Forensic Nurses: www.iafn.org
Now more than ever, healthcare frequently becomes enmeshed with the legal system, creating numerous opportunities for healthcare providers in the field of forensic health. The word forensic means "pertaining to the law." Forensic nursing applies to those instances where nurses interact with the law or legal issues. Forensic nursing is the application of nursing science to public or legal proceedings, the application of the forensic aspects of nursing in the scientific investigation and treatment of trauma and/or death of victims and perpetrators of abuse, violence, criminal activity, traumatic accidents, and environmental hazards. Forensic nurses work in a number of settings with a variety of clients: sexual assault victims and perpetrators; victims and perpetrators of domestic violence, child abuse, and elder abuse; juvenile delinquents; victims of traumatic accidents; clients with criminal backgrounds; and mentally disturbed offenders. Forensic nurses can also: work in the coroner's office on death investigations; assist law enforcement in collecting evidence; act as legal consultants; work with medical malpractice issues; work in organ and tissue donation; deal with environmental issues (food and drug tampering, hazards, terrorism, epidemiological issues); and create violence prevention programs. Healthcare settings that deal with forensic issues include, but are not limited to: emergency treatment facilities, schools, correctional facilities, psychiatric settings, and outpatient and community health settings. Forensic health research is a rapidly growing area.
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